'Sleep-starved' VIPs keep Chest Hospital on toes

HYDERABAD: The state-run Chest Hospital at Erragadda might be a strict no for the city's who's who but, of late, the rundown facility has been getting unlikely patients at its doorstep with the visitors including MLAs, IAS officers, engineers and doctors. The hospital is now struggling to keep pace and is sometimes being forced to give priority to its VIP patients who doctors say are "sleep deprived". And Chest Hospital, with its full-fledged Sleep Lab, is helping them find a solution to their daytime sleepiness by studying their sleep overnight and prescribing the treatment accordingly.

Not just VIPs but hundreds of sleep deprived Hyderabadis are suffering from Obstructive Sleep Apnoea (OSA), a common sleep disorder characterized by snoring and daytime sleepiness. Patients complain of dozing at work or worse while driving and in most cases of snoring loudly. Alarmingly, the hospital has been getting a steady flow of RTC drivers among others for sleep tests. Experts note that snoring, waking up in the middle of night, gasping and choking, causing automobile or work-related accidents and daytime sleepiness are signs of OSA. Diagnosis is possible only through a sleep test at a sleep lab. Vizag Chest Hospital is the second facility in the public sector and Apollo Hospital in the private sector which have well-equipped sleep labs. While some private hospitals are offering home-based sleep studies for which they are charging a bomb (Rs 8,000), they are not authentic, experts say.

"Surgical correction is possible only in 25%-30% of the patients. Most of the patients have to use a mask which is attached to a machine that continuously blows air into their nose called CPAP. The machine costs anywhere between Rs 35,000 and Rs 1 lakh. This has to be used for at least 4-5 hours daily," said Dr PNS Reddy, superintendent of Chest Hospital. The hospital performs 8-12 sleep studies a month and charges Rs 2,000 for the six-hour long study.

Doctors contradict the assumption that snoring indicates deep sleep by calling it a health hazard. "It was only during the last decade that snoring has been recognized as a health hazard in India. Snoring is unhealthy, unnatural and potentially harmful to life," says Dr TV Krishna Rao, senior ENT specialist who sees at least five new sleep apnoea patients every week. His latest patient is a 35-year-old medical store operator weighing 100 kilos who complains of night gasping and choking. He adds that sleep apnoea is largely an under-diagnosed condition which can be fatal because it prevents breathing while sleep. Each pause in breathing is called apnoea and these pauses may occur from 5-30 times or more in an hour.

Mild occasional sleep apnoea, which many people experience during an upper respiratory infection, may not be important, but chronic OSA requires treatment to prevent low blood oxygen, sleep deprivation and other complications. Specialists say that OSA is more common among people who are obese and have a sedentary lifestyle. While the incidence is more common in males, as the age increases incidence also goes up among women. Also, it is more common in smokers and those who take alcohol in the night. Alcohol decreases upper airway muscle tone which in turn increases severity of snoring and apnoea, specialists note.

Doctors say that most people are often oblivious to their snoring problem. Dr Vinay Kumar, ENT specialist with Apollo who has performed around 200 corrective surgeries, says that most women tolerate their husband's snoring. Dr K Subhakar, pulmonologist with Chest Hospital, adds that people tend to go to psychiatrists who prescribe sedatives for this problem.